Discrimination and the stigma attached to poverty may contribute to physiologic changes associated with poorer health, U.S. researchers suggest.

Lead author Dr. Thomas Fuller-Rowell of the University of Wisconsin-Madison, who is a Robert Wood Johnson Foundation Health & Society Scholar, said although the link between poverty and poor health has been long known, this study considered the impact of class discrimination.

The study involved 252 17-year-olds from upstate New York enrolled in a long-running Cornell University study on rural poverty.

All were white but the study did not look at the effect of race.

“Experiences of discrimination are often subtle rather than blatant, and the exact reason for unfair treatment is often not clear to the victim,” Fuller-Rowell said in a statement. “For these reasons, rather than asking the study participants if they had experienced discrimination specifically based on their class background, the study measured general perceptions of discrimination. For example, they were asked: ‘How often do people treat you differently because of your background?'”